{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T15:44:39Z","timestamp":1772639079807,"version":"3.50.1"},"reference-count":31,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Cerebral spinal fluid (CSF) diversion methods, including ventriculoperitoneal (VP) shunts, are the standard treatment for hydrocephalus. Hair clipping (HC) has been a routine neurosurgical practice of the great majority of neurosurgeons, due to the perception that this will either decrease the risk of shunt infection or allow for a faster, unimpeded opening and closing of the skin. The benefits of not cutting or clipping hair in terms of normalizing appearance and self-esteem are obvious. The purpose of this study was to assess whether the rate of shunt infection would differ between pediatric patients receiving operation via the hair-sparing (HS) approach versus HC.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>A retrospective single-institution study comparing HS versus HC was conducted on pediatric patients undergoing long-term CSF shunt procedures at the Montreal Children\u2019s Hospital between August 2014 and April 2021. The primary outcome measure was shunt infection at 90 days and at long-term follow-up. Inclusion criteria were having at least 18 months of follow-up after long-term CSF shunt procedures, including insertions or revisions of VP shunts, ventriculoatrial shunts, cystoperitoneal shunts, subdural-peritoneal shunts, ventriculosubgaleal shunts, and ventriculosubgaleal reservoirs. Excluded procedures were those involving external ventricular drains, externalized shunts, Omaya reservoirs, endoscopic third ventriculostomies, and lumbar shunts.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>There were 434 CSF shunt procedures performed in 226 unique patients; 155 (35.71%) procedures were done using the HS approach versus 279 (64.29%) procedures via HC. At 90 days postoperatively, the infection rate was 1.29% in the HS group and 2.87% in the HC group, with an absolute risk difference of 1.58% (95% CI \u22121.07% to 4.23%, p = 0.24). At long-term follow-up (mean follow-up: 752 days and 716 days for the HS and HC groups, respectively), the rate of shunt infection remained at 1.29% for the HS group (no new infections) but rose to 4.66% for the HC group, with an absolute risk difference of 3.37% (95% CI 0.33%\u20136.41%, p = 0.03).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Performing CSF shunt procedures without cutting or clipping any hair has a very low risk of shunt infection, and certainly does not appear to increase the risk of infection (or malfunction) versus the hair removal approach. It is a safe alternative and should be considered due to its esthetic and psychological benefits regarding normalization of appearance and ease of resuming a normal life following shunt surgery.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.8.peds23548","type":"journal-article","created":{"date-parts":[[2024,11,16]],"date-time":"2024-11-16T02:29:44Z","timestamp":1731724184000},"page":"1-9","source":"Crossref","is-referenced-by-count":1,"title":["Hair-sparing approach versus traditional hair clipping for cerebral spinal fluid shunt procedures: a retrospective comparative study"],"prefix":"10.3171","author":[{"given":"Saman","family":"Arfaie","sequence":"first","affiliation":[{"name":"Division of Neurosurgery, Department of Pediatric Surgery, McGill University, Montr\u00e9al, Qu\u00e9bec, Canada;"},{"name":"Division of Neurosurgery, Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Sarabi","sequence":"additional","affiliation":[{"name":"Arizona State University, School of Computing and Augmented Intelligence, Tempe, Arizona;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arad","family":"Solgi","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Pediatric Surgery, McGill University, Montr\u00e9al, Qu\u00e9bec, Canada;"},{"name":"Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eve","family":"Michaud","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Pediatric Surgery, McGill University, Montr\u00e9al, Qu\u00e9bec, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eliana","family":"Rohr","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Pediatric Surgery, McGill University, Montr\u00e9al, Qu\u00e9bec, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Giampa","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Pediatric Surgery, McGill University, Montr\u00e9al, Qu\u00e9bec, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elyssia","family":"Ieropoli","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Pediatric Surgery, McGill University, Montr\u00e9al, Qu\u00e9bec, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oliver","family":"Lasry","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery, Montreal Neurological Hospital and Institute, McGill University, Montr\u00e9al, Qu\u00e9bec, Canada; and"},{"name":"Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roy W. R.","family":"Dudley","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Pediatric Surgery, McGill University, Montr\u00e9al, Qu\u00e9bec, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"J Neurosci Nurs","first-page":"149","article-title":"Does preoperative scalp shaving result in fewer postoperative wound infections when compared with no scalp shaving? A systematic review","volume":"44","author":"Sebastian S","year":"2012","unstructured":"Sebastian S. Does preoperative scalp shaving result in fewer postoperative wound infections when compared with no scalp shaving? A systematic review. 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